Mary Emily Titcomb, PNP

Primary specialty

Pediatric Nurse PractitionerTaxonomy code 363LP0200X

License

28116030A Issued in IN

Practice address

1717 S Calhoun St
Fort Wayne, IN 46802-5257

Phone

(260) 458-2641

Fax

(260) 458-3093

NPI assigned

Aug 17, 2006

Sex

Female

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1155772800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1205940442",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 11949",
            "city": "FORT WAYNE",
            "state": "IN",
            "postal_code": "468621949",
            "telephone_number": "260-458-2641",
            "fax_number": "260-458-3093"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1717 S CALHOUN ST",
            "city": "FORT WAYNE",
            "state": "IN",
            "postal_code": "468025257",
            "telephone_number": "260-458-2641",
            "fax_number": "260-458-3093"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TITCOMB",
        "first_name": "MARY",
        "middle_name": "EMILY",
        "name_prefix": "Mrs.",
        "credential": "PNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-08-17",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Pediatrics",
            "state": "IN",
            "license": "28116030A",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PNP",
            "identifier": "84474-06",
            "state": "IN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Jennifer Tippmann, D.P.T.
• Stephanie Tippmann
• Lauren Tirey, OTR
• Laura K Tirpak, PA
• Clifton Paul Titcomb Jr., M.D.
• Nicholas Ray Tjeerdsma, ATC
• TLC Dental LLC
• TLC Hearing Center Inc.
• TMJ & Sleep Therapy Centre of Fort Wayne, LLC
• Jennifer L Tobin, PA

• Pediatric Nurse Practitioner in Fort Wayne, IN
• Providers in Fort Wayne, IN by specialty
• Pediatric Nurse Practitioner in Indiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.